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Individual

MS. SUSAN LORRAINE REID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
8209 113TH ST, SEMINOLE, FL 33772-4128
(727) 543-2144
Mailing address
1028 COMMODORE ST, APT 4, CLEARWATER, FL 33755-1014
(727) 543-2144

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA6609
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C1838
BLUE CROSS BLUE SHEILD
FL
Enumeration date
06/05/2009
Last updated
06/05/2009
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